• Valerie Henderson and Mokgadi Kholofelo Mashola.
• Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
• Pain Pract. 2024 Nov 19.

BackgroundCommunity reintegration is an important goal for people living with a spinal cord injury (SCI), and pain is suspected to limit reintegration due to its limitations in daily functioning, mood, and sleep.ObjectivesTo determine the influence of pain on community reintegration in manual wheelchair users with SCI.MethodsThe Reintegration to Normal Living Index was used to determine community reintegration, while the DN4 and the Wheelchair User's Shoulder Pain Index were used to determine the presence of neuropathic and shoulder pain respectively. Associations and differences between the pain variables and participants with and without pain were analyzed with Spearman correlations and Mann-Whitney U-tests using SPSS v27 at 0.05 significance level and 95% confidence interval.ResultsOf the 122 participants, 85.2% reported current pain, with a 77.7% median for community reintegration. Neuropathic pain (53.3%) was more common and severe than nociceptive shoulder pain (14.8%). There was no significant difference in community reintegration between participants with and without pain, nor any correlation between the overall presence of pain and community reintegration. The severity of pain, particularly shoulder pain, was negatively associated with taking trips out of town (p < 0.01), and overall community reintegration (p < 0.05).ConclusionIt is not the mere presence of pain that influences community reintegration, but rather the severity and the location of pain. Shoulder care and pain management need to be included in the rehabilitation program, as these are important considerations when rehabilitating people with SCI back into their communities.© 2024 The Author(s). Pain Practice published by Wiley Periodicals LLC on behalf of World Institute of Pain.

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